Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

Introduction: the Study of Argumentation Although our overall organization of the readings suggests one way of dividing our selected literature, ...

A high percent of oxidative energy metabolism is needed to support brain growth during infancy. Unhealthy diets and limited nutrition, as well as other environmental insults, can compromise these essential developmental processes. In particular, iron deficiency anemia has been found to undermine both normal brain growth and neurobehavioral development. Even moderate ID may affect neural maturation because when iron is limited, it is prioritized first to red blood cells over the brain. A primate model was used to investigate the neural (...) effects of a transient ID and if deficits would persist after iron treatment. The large size and postnatal growth of the monkey brain makes the findings relevant to the metabolic and iron needs of human infants, and initiating treatment upon diagnosis of anemia reflects clinical practice. Specifically, this analysis determined whether brain maturation would still be compromised at 1 year of age if an anemic infant was treated promptly once diagnosed. The hematology and iron status of 41 infant rhesus monkeys was screened at 2-month intervals. Fifteen became ID; 12 met clinical criteria for anemia and were administered iron dextran and B vitamins for 1–2 months. MRI scans were acquired at 1 year. The volumetric and diffusion tensor imaging measures from the ID infants were compared with monkeys who remained continuously iron sufficient. A prior history of ID was associated with smaller total brain volumes, driven primarily by significantly less total gray matter and smaller GM volumes in several cortical regions. At the macrostructual level, the effect on white matter volumes was not as overt. However, DTI analyses of WM microstructure indicated two later-maturating anterior tracts were negatively affected. The findings reaffirm the importance of iron for normal brain development. Given that brain differences were still evident even after iron treatment and following recovery of iron-dependent hematological indices, the results highlight the importance of early detection and preemptive supplementation to limit the neural consequences of ID. (shrink)

The Drosophila salivary gland has emerged as an outstanding model system for the process of organ formation. Many of the component steps, from initial regional specification through cell specialization and morphogenesis, are known and many of the genes required for these different processes have been identified. The salivary gland is a relatively simple organ; the entire gland comprises of only two major cell types, which derive from a single contiguous primordium. Salivary cells cease dividing once they are specified, and organ (...) growth is achieved simply by an increase in size of individual cells, thus eliminating concerns about the potential unequal distribution of determinants during mitosis. Drosophila salivary glands form by the same cellular mechanisms as organs in higher organisms, including regulated cell shape changes, cell intercalation and directed cell migration. Thus, learning how these events are coordinated for tissue morphogenesis in an organism for which the genetic and molecular tools are unsurpassed should provide excellent paradigms for dissecting related processes in the more intricate organs of more complicated species. BioEssays 23:901–911, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

This book examines influential conceptions of sport and then analyses the interplay of challenging borderline cases with the standard definitions of sport. It is meant to inspire more thought and debate on just what sport is, how it relates to other activities and human endeavors, and what we can learn about ourselves by studying sport.

We defend the view of some feminist writers that the notion of silencing has to be taken seriously in discussions of free speech. We assume that what ought to be meant by ‘speech’, in the context ‘free speech’, is whatever it is that a correct justification of the right to free speech justifies one in protecting. And we argue that what one ought to mean includes illocution, in the sense of J.L. Austin.

Much research on women’s religious participation centers on their abilities to act within constricted institutional spaces. Drawing on five years of ethnographic fieldwork, this study analyzes how African American Muslim women use the mosque as a physical space to enact public performances of religious identity. By occupying, protecting, and appropriating spaces in the mosque for meaningfully gender-specific ways of engaging Islam, the women further a project of religious self-making that bonds African American Muslim women together. In their maneuverings of different (...) forms of physical space as a sisterhood, the women enable themselves to resist gender, economic, and racial oppression. This study reveals that even within men-dominated religious organizations with limited symbolic and material spaces for women, women participants successfully exert agency over their own religious experiences. (shrink)

Although _Seibutsu no Sekai _, the seminal 1941 work of Kinji Imanishi, had an enormous impact in Japan, both on scholars and on the general public, very little is known about it in the English-speaking world. This book makes the complete text available in English for the first time and provides an extensive introduction and notes to set the work in context. Imanishi's work, based on a very wide knowledge of science and the natural world, puts forward a distinctive view (...) of nature and how it should be studied. Imanishi's work is particularly important as a background to ecology, primatology and human social evolution theory in Japan. Imanishi's views on these subjects are extremely interesting because he formulated an approach to viewing nature which challenged the usual international ideas of the time, and which foreshadow approaches that have currency today. (shrink)

The recent political “left turn” in Latin America has led to an increased emphasis on social policy and poverty alleviation programs aimed at women. Drawing on ethnographic fieldwork and interviews in a rural village in Nicaragua, I argue that one of the consequences of such programs is an increase in women’s daily workload, which I call the gendered burden of development. By exploiting women’s unpaid community care labor, these non-governmental organizations and state-led programs entrench established gender roles and responsibilities. Furthermore, (...) through their selective interventions, these programs reinforce the neoliberal ideal of self-sufficiency in women’s everyday lives, contributing to the formation of a particular kind of developmental subject who assumes responsibility for her own hardships. Although these programs have produced some tangible improvements in women’s lives, they ultimately do little to alter the structural conditions affecting the precariousness of women’s survival. (shrink)

J.L. Ackrill's work on Plato and Aristotle has had a considerable influence upon ancient philosophical studies in the late twentieth century. This volume collects the best of Ackrill's essays on the two greatest philosophers of antiquity. With philosophical acuity and philological expertise he examines a wide range of texts and topics--from ethics and logic to epistemology and metaphysics--that continue to be in the focus of debate.

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

What does it mean to be ethical in psychotherapy? Does adherence to ethical codes and rules make a psychotherapist ethical? This article examines standard ways of thinking about ethics in the field and argues that these ways are inadequate, creating a false dichotomy between the ethical and the clinical, and that they are designed only for formal and contractual relationships, in which psychotherapy is more often personal and affecting. The ethic of care and the approach to ethics of Emmanuel Levinas (...) are presented as additional approaches, along with their challenges to rationality and autonomy. An ethic of listening is then presented, and it is argued that ethics should be not an afterthought, but the primary consideration of clinical utility. (shrink)

In Deep Space Nine's Chief of Security Odo is one who finds his identity in his job, which is a sufficient burden to keep him plenty occupied. In a more benign laboratory than what Odo experienced, philosophical instead of exobiological, he presents an ideal case study of George Herbert Mead's theory of how the self is formed and transformed. According to Mead, language starts with meaningful gestures. When creatures act in coordination through a gesture, signaling that the gesture means the (...) same to them; it becomes language. Focused attention is one of the ways one has of influencing the clarity and extent of memories. Over the arc of Deep Space Nine's tales, all the characters change. Yet Odo goes from being a one‐dimensional to a multidimensional character by learning languages from those who start out as generalized others, but become specific others as time goes on. (shrink)

This book uses the example of informed consent guidelines for international research on human subjects to demonstrate how a philosophical analysis can assist in understanding how underlying concepts affect public policy; how and why such policies are exclusionary; and what methodology can be used to remedy injustices in public policy and practice. Epidemics, such as AIDS, have resulted in an increase in medical research in less developed countries. In an attempt to be more globally applicable, current international guidelines for research (...) on human subjects have attempted to acknowledge the importance of community. This book explains how these attempts fail to adequately acknowledge the importance community has for many people in less developed countries, and how these guidelines fail to attend to constraints to autonomy that oftentimes get magnified once community is involved in the informed consent process. The book further explains how these problems can be traced to a mistaken underlying notion of autonomy and what policymakers can do to remedy these problems . (shrink)

Confusion remains about the concept “nursing science.” Definitions vary, depending on country, context and setting. Even among nurse scholars and scientists there is disagreement about the content and boundaries of nursing science. There is an urgent need for an acceptable definition that can guide nursing knowledge development, education, and practice. In this article, we highlight the problems for the profession of this sort of conceptual ambiguity, arguing that it is an ethical responsibility for the profession to gain clarity about the (...) meaning and apt focus of our knowledge development initiatives. We parse out nursing and science as separate concepts and synthesize from this analysis a simple yet comprehensive definition of nursing science. We propose that this definition is capable of unifying ongoing nursing endeavors and should serve as the basis for evaluating nursing's knowledge development and educational initiatives. (shrink)

In spite of the seemingly omnipresent corruption and Mafia activity plaguing modern Russia it is nevertheless possible, and desirable, to conduct business ethically there, as the author testifies. Pamela Woolley has recently completed a full time MBA at London Business School, prior to which her career was in international telecommunications. She has long been interested in Russia and worked in Moscow during the summer between her two years of study. The experience has prompted her to seek a more permanent (...) position in the region and was the impetus behind writing this article. She also wishes to thank Dr Jan Dauman of InterMatrix Group for his interest and contribution to the information gathered in the preparation of this article. (shrink)

In spite of the seemingly omnipresent corruption and Mafia activity plaguing modern Russia it is nevertheless possible, and desirable, to conduct business ethically there, as the author testifies. Pamela Woolley has recently completed a full time MBA at London Business School, prior to which her career was in international telecommunications. She has long been interested in Russia and worked in Moscow during the summer between her two years of study. The experience has prompted her to seek a more permanent (...) position in the region and was the impetus behind writing this article. She also wishes to thank Dr Jan Dauman of InterMatrix Group for his interest and contribution to the information gathered in the preparation of this article. (shrink)

This commentary argues that the concept of news is a primitive term, one whose existence is not questioned, and that assumptions about the news need to be identified and questioned. One common assumption is that news is composed of things that are newsworthy, i. e., that news and newsworthiness are essentially the same, and that the prominence with which an event is covered in the news is an indicator of newsworthiness. Shoemaker's recent research with Akiba Cohen shows that news and (...) newsworthiness are in fact not the same. News is a social construct, a thing, a commodity, whereas newsworthiness is a cognitive construct, a mental judgment. Newsworthiness is not a good predictor of which events get into the newspaper and how they are covered. Newsworthiness is only one of a vast array of factors that influence what becomes the news and how prominently events are covered. (shrink)

Nurses have a long tradition of storytelling. Nurses in the New Zealand government’s Backblocks Nursing Service, established in 1909 for settlers in remote rural areas, related narratives of personal experience in articles, conference papers and letters to their chief nurse that were published in the country’s nursing journal. Analysis of the 16 stories published between 1910 and 1915 revealed 14 had a common storyline and structure. Structural elements included a call, arduous journey, arrival and reconnaissance, trial (difficult case or circumstance), (...) resolution and homily. Using a literary folkloristics approach, this article argues that repetition of the story by nurses in different regions traditionalised it as a professional folktale, ‘The nurse’s odyssey’. It enabled nurses to debrief from difficult cases and write‐into‐being this new role and practice. Striking differences in the practice setting ensured the story’s reportability, while clinical details connected writer and readers through a common professional aesthetic context and strengthened the story’s credibility. For the chief nurse who was also a journal editor, publishing the stories allowed her to potentially attract nurses to the service while alerting them to its harsh realities, and show policy‐makers the profession’s value in meeting new health service needs. (shrink)